Background: The overlap between stress and reward system has been documented with growing evidence. Alterations in stress system may increase the vulnerability to drug addiction but harmful drug use may impact on stress reactivity. Methods: The main purpose of this study was to estimate the extent of differences between Heroin Use Disorder (HUD) patients who presented, during the treatment, a Post Traumatic Stress Disorder spectrum (H/PTSD-S) and those who did not. These two groups were compared, using standardized instruments, at univariate and multivariate levels, regarding the natural history of the disorder, the psychopathology and the craving-related behaviours during a treatment with opioid agonist medications (AOT). Results: H/PTSD-S patients were more frequently women without partners and with blue-collar or unemployed jobs. They showed problematic social adjustment and in their natural course of heroin addiction showed increased harmful substance use, especially with regard to benzodiazepines. If they maintained addictive behaviours during treatment, risky-, exchange-and time-behaviours were prominent and were characterized by the inappropriate use of no-rewarding substances when rewarding or substitute drugs came to lack. In addition, they maintained a boost to the use of opioids when stimulated by heroin presence or being in contact with people who intake heroin. Finally, these patients maintained a greater severity of psychopathology during treatment. Conclusion: Detecting of an abnormal stress reaction in HUD patients (H/PTSD-S) may be proposed as a suitable means of monitoring treatment outcomes and effectiveness. © 2020, Pacini Editore S.p.A.. All rights reserved.

Prominent psychopathological and clinical characteristics of Heroin Post- Traumatic Stress Disorder Spectrum patients during treatment

Maremmani, Icro
;
Maremmani, Angelo G. I.
2020-01-01

Abstract

Background: The overlap between stress and reward system has been documented with growing evidence. Alterations in stress system may increase the vulnerability to drug addiction but harmful drug use may impact on stress reactivity. Methods: The main purpose of this study was to estimate the extent of differences between Heroin Use Disorder (HUD) patients who presented, during the treatment, a Post Traumatic Stress Disorder spectrum (H/PTSD-S) and those who did not. These two groups were compared, using standardized instruments, at univariate and multivariate levels, regarding the natural history of the disorder, the psychopathology and the craving-related behaviours during a treatment with opioid agonist medications (AOT). Results: H/PTSD-S patients were more frequently women without partners and with blue-collar or unemployed jobs. They showed problematic social adjustment and in their natural course of heroin addiction showed increased harmful substance use, especially with regard to benzodiazepines. If they maintained addictive behaviours during treatment, risky-, exchange-and time-behaviours were prominent and were characterized by the inappropriate use of no-rewarding substances when rewarding or substitute drugs came to lack. In addition, they maintained a boost to the use of opioids when stimulated by heroin presence or being in contact with people who intake heroin. Finally, these patients maintained a greater severity of psychopathology during treatment. Conclusion: Detecting of an abnormal stress reaction in HUD patients (H/PTSD-S) may be proposed as a suitable means of monitoring treatment outcomes and effectiveness. © 2020, Pacini Editore S.p.A.. All rights reserved.
2020
Abnormal stress reactivity
Craving-related behaviours
Heroin Use Disorder
Methadone treatment
Natural history of drug addiction
Specific psychopathology of drug addiction
Spectrum PTSD
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.14245/9077
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 3
social impact